Strain Imaging by Speckle Tracking for the Assessment of Diastolic Dysfunction in Beta-Thalassemia Major Patients
Objectives: Strain imaging is a novel promising echocardiographic technique and strain imaging by speckle tracking has been reported recently in a few studies as a promising tool to detect early changes of myocardial deformation that could be related to myocardial iron over load in patients with β-thalassemia major. In this study, we investigated strain images in comparison with the cardiac T2* magnetic resonance imaging results.
Materials and Methods: A total of 45 patients from a single institution’s pediatric and adult hematology centers were evaluated with strain echocardiography and T2* magnetic resonance imaging at concomitant out-patient visits. We grouped patients according to cardiac T2* magnetic resonance imaging results: <20 ms (Group 1, cardiac iron loading present) (n=12) and ≥20 ms (Group 2, no clinically significant cardiac iron loading) (n=33).
Results: The median global longitudinal strain was measured as -19.9% (range -27.1% to -12%) in Group 1 and -20.7% (range -26.5% to -12.8%) in Group 2 (p=0.37). Using receiver operator curve analysis, global longitudinal strain value at a cutoff point of -20.45% in the ruling out T2*<20 ms with a sensitivity of 83% and a specificity of 54% was obtained.
Conclusion: In conclusion, although T2* magnetic resonance imaging is the gold standard method, strain imaging echocardiography can be used for predicting cardiac iron accumulation, after validations were obtained in larger sample sizes.
Copyright (c) 2021 Acta Medica
This work is licensed under a Creative Commons Attribution 4.0 International License.